Making the Connection

By Laura Thill

Patients today respond to digital marketing.

Xavier Dao

Today, few households in America do not revolve around smartphones, iPads and desktop/laptop computers. Indeed, dental patients – from pediatric to the elderly – are likely spending a good amount of time accessing their world through some type of digital device. Dental practices that don’t take advantage of digital marketing are missing out on an opportunity to introduce themselves to new patients and stay in touch with current ones, according to Xavier Dao, senior director of marketing, Pacific Dental Services® (PDS®).

“Over the past 20 years, more and more people have come to depend on their desktop/laptop computer, smartphone and tablet to gain access to content,” says Dao. The growth in popularity of these devices has driven dental professionals to rely on digital marketing to target new and existing patients, he points out.

“Digital marketing encompasses any form of marketing that utilizes electronic devices or the Internet,” Dao continues. But, while electronic devices can be narrowed down to smartphones, tablets or other types of computer devices, the array of digital marketing channels available to dental practice owners can be overwhelming, he notes. “Digital marketing channels include websites, search engines (both paid and organic), social media, email, SMS (text messages), content marketing and digital display advertising.” And this is only the tip of the iceberg. “There are many other channels as well, each with additional layers,” he says. “Digital marketing is not only one of the best ways to reach new and existing patients, it’s also one of the most complex ways.”

“Refining audience segments is an art requiring both creative and analytic processes,” Dao explains. “The continual optimization process is never-ending, especially today, when new mechanisms within each channel are continually introduced.”

Tools at their disposal
The good news for dental professionals is that more and more patients use the Internet to actively seek providers. At the same time, dental service organizations like PDS have developed tools to help their supported clinicians target specific patient groups. As long as people have access to an electronic device or are connected to the Internet, digital marketing can be very effective, notes Dao.

“At PDS, we help our supported clinicians target patient groups who have expressed an interest in oral healthcare,” he says. “Patient groups can express their interest in several ways: They may conduct a Google search, visit a dental practice’s website, respond to a comment on the practice’s Facebook page or simply respond to emails.

“As an example, Pacific Dental Services® has refined its PRIVATE PRACTICE +® model, a supported means of autonomy that allows dental professionals to concentrate on clinical excellence and the highest levels of cost-effective comprehensive patient care, while PDS provides the support structure for the business functions. Our owner dentist model allows us to support thousands of clinicians across the country, so that they can focus on their patients while we take care of running the business. We support both local dental office brands and national brands through the industry-leading strategic development of cross-channel marketing campaigns, tools and guidance.”

That said, PDS is careful to focus on the dental practice as an entity, Dao adds. Whether the dental practice owner, an office manager or the regional operations manager communicates a need for support, PDS responds quickly and efficiently. “PDS offers a subset of tools for the entire dental team,” Dao says. “For instance, we may help them update their website and make it more usable. Or, the dental practice may reach out to help them make better use of Facebook. Our DSO model is as follows: to act as a support system for the whole dental practice. Our goal is to help them take full advantage of the tools they have at their disposal.”

Dao is confident that digital marketing will continue to evolve as people spend more time engaging with electronic devices. “Moving forward, dental practices will take advantage of mobile payments to facilitate the payment process,” he points out. “Voice products will help them reach and interact with patients.” And the growth of artificial intelligence will make it easier and more efficient to target patient populations, he adds. “As digital marketing continues to evolve, the dental industry will have to embrace new technology and new channels to deliver the services patients will come to expect.”

A Tale of Two Brands

Tech-savvy dental professionals today have plenty of products at their disposal, most of which will deliver great results. So, what makes a practice choose one product solution over another – and then stick with it? In a word: the brand. Creating a brand that customers identify with and trust can be a tricky business, however. Efficiency in Group Practice asked a couple of experts what branding means to their company, and how they build their customers’ trust.

A better experience
Villa Radiology Systems builds its brand by “always striving to give our clients a better experience,” according to company COO Paul Blocchi. That means maintaining a close relationship with dental clients, he notes. “Whether a product is sold through a distributor partner or directly, it’s very important that our clients contact us directly with any questions or concerns,” he explains. That said, Villa Radiology Systems doesn’t hesitate to involve its distributor partners when it’s in the best interest of their clients, he adds. “Our branding campaigns combine timeless values with leading-edge technology to consistently give both our clients and partners the best possible training and support experience throughout the product lifecycle.”

Villa Radiology System’s mission to deliver a value-added client experience has remained intact through the years. At the same time, the company has refined its approach to stay current in a changing industry. Particularly as the price of large equipment has dropped in recent years, it has become increasingly important for manufacturers to give clinicians the value they expect, and to do so more efficiently, notes Blocchi. “At Villa Radiology Systems, we’ve addressed this through mass commoditization,” he says. “For example, some dental imaging equipment is selling at a market price of 67 percent lower than just eight years ago,” he says. “We must provide a better client experience throughout the entire product lifecycle, and work very cost effectively to build our brand position in the Americas.” Villa Radiology has streamlined its operations in recent years, creating an open wall policy that enables it to share “the right knowledge at the right time with the right partners,” he adds.

This trend will continue in years to come, says Blocchi. “In spite of having fewer resources, dental manufacturers will have to provide a better experience to both the dental professionals and distribution partners in order to effectively build or maintain their brand position in the marketplace.”

A strong identity
Air Techniques believes it’s important to provide customers with a strong product identity – a strategy that’s largely tied to the company’s mission to educate and build trust among the public. “Branding encompasses every identifier we create, from our company logo to literature, packaging, signage, ads, trade show displays and more,” says Laura Walsh, marketing manager. “As a dental manufacturer, it’s important that we provide dental professionals with the products they need to create the most efficient and effective patient workflow; At the same time, we must provide them with educational seminars and webinars to ensure they stay up-to-date on the ever-changing technology.”

That said, Air Techniques appreciates the varied needs and interests of its customer base from one area to the next. So, whereas water consumption is an issue on the West Coast, for other customers, the larger issue may be designing an office within a small space. “Some of our customers depend on our eco-friendly Mojave dry vacuum system, which is designed to reduce water usage,” Walsh points out. “For other customers, the solution may be our Mojave LT vacuum system, which includes a compact footprint for dental offices with limited space.”

Digital marketing
As dental professionals have come to depend on social media to help them stay current on new products and technologies, companies like Air Techniques have expanded their branding strategies to remain industry leaders. “Digital marketing has definitely impacted our branding strategy over the last five years,” says Walsh. “Dental professionals are using social media more than ever to share ideas and successes, as well as to learn about new products or to earn continuing education credits.” As some clinicians have come to rely more on social media sites, they have felt less need to attend traditional trade shows, she adds. In turn, Air Techniques has significantly increased its digital communications to dental professionals, including posts via social media, blogs, email campaigns and website links.

There’s no doubt that Air Techniques’ digital marketing efforts have impacted the company’s branding campaigns, according to Walsh. “Our digital marketing campaigns today outnumber our traditional print marketing campaigns, two to one,” she points out, noting that the growth of larger group practices and DSOs likely will further impact this trend in the next several years. “We have initiated new branding efforts that target large group practices via specialty trade shows and digital marketing campaigns,” she says.

One Message, Many Audiences

Maintaining a consistent brand across a large organization isn’t easy, particularly when the target audience is so diverse.

By Laura Thill

At the heart of every organization is its brand, a powerful image that comes to mind whenever the organization is mentioned. When viewed as a cohesive effort within the organization to build a trusting relationship with current and potential clients, branding can unite its members and motivate them to convey a winning message to the public.

“At Mortenson Dental Partners, our brand is who we are in the minds of our patients, and future patients,” says Jacque Ramsey, Mortenson’s director of marketing. “It is one of the most valuable and important assets of our organization. We teach and empower all of our team members that they are brand ambassadors who shape our brand in a more influential way than signage or a TV commercial ever could.

“Our main objective with regard to branding is to communicate a trusting and professional image,” she continues. “We want patients to feel they can count on us to service their dental needs in a comfortable environment, to educate them on the care prescribed and to deliver desirable outcomes.” And they know their branding efforts have been successful when a patient hears the DSO’s message via social media or a personalized text, connects with a Mortenson practice and has an exceptional experience, she adds.

When a brand is strong, it reaches across a variety of audiences, Ramsey points out. “We focus on building a brand that resonates with potential patients, existing patients, future team members, current team members and audiences within the dental industry.” Each of these audiences may require a different message, but each message conveys who Mortenson is as an organization and why that should matter, she explains.

Subhead: Consistent but diverse

A large dental service organization may find it challenging to maintain brand consistency throughout the organization, according to Ramsey. For instance, people don’t always understand the impact of minor tweaks on the integrity of the brand over time, she points out. “It is important that we always use the same font, tone, colors, language, etc.,” she says. “When people try to create a message on behalf of the brand that is not in alignment with all of the brand standards, the value of the brand begins to decline.”

The more people representing the brand, the more difficult it can be to maintain consistency, Ramsey continues. “We work hard to educate our team members that they –not a billboard – are the face of our brand. Their actions matter; the way they present themselves and treat others is a direct reflection of our brand.”

At the same time, a large DSO must ensure its brand appeals to a diverse group of people. Typically, an audience identifies with others who share the same region, culture, age and more. “We typically have one brand in each market we operate,” says Ramsey. “This allows us to tailor our message to a specific community, while maintaining the consistency of our brand. We also consider generational differences in our approach, looking not only for the best messaging to resonate with different generations, but the best media as well.”

Carrying multiple brands isn’t easy, she notes. “But, the ability to customize our message, voice, tone, look and feel helps us reduce our risk if there is a brand-damaging event,” she explains. So, for example, Mortenson’s pediatric brand enables the DSO to address parents much differently than it would reach out to the same group of adults regarding their own dental care, she adds.

Subhead: An evolving industry

Dentistry is not immune to change, and as the industry evolves, so too must a DSO’s brand. “When Mortenson Dental Partners was originally created, we were a group of like-minded partner practices,” says Ramsey. “In the last 10 years, we have repositioned our business strategy to be that of a cohesive company rather than a variety of partnerships. This shift has led us to redefine our mission and values to better reflect our history and set the stage for our future.” This, in turn, has provided a solid foundation for the DSO’s branding efforts, she notes. “Today, Mortenson’s brand communicates that we Care for Everyone, Share Abundantly, Build Relationships, Express Gratitude and work every day to Improve the Lives of Others by Living Our Values Every day.” If this message isn’t getting across to the target audience, “we need to rethink what we are trying to say and how.”

Mortenson’s approach to branding will likely continue to evolve as dental care becomes more innovative, says Ramsey, who anticipates consumers will increasingly regard dental professionals as service providers. And, a new mindset means new expectations. Patients will expect faster service, but not at the expense of quality, she points out. They will want transparency when it comes to diagnoses and solutions, and they will rely on a network of peers to validate choices, she notes. “And they will not tolerate mistakes if there is not a strong relationship with the brand to begin with,” she says.

In the future, it will be imperative for DSOs to support their marketing decisions with actual data, says Ramsey. “By doing so, we will be able to communicate specific messages to specific audiences. Understanding our patients better will not only allow us to market to them better, but to also deliver custom patient experiences that wow the patient and build patient loyalty. This approach will help us eliminate waste and be more intentional in the way we connect to patients.”

Technological advances in artificial intelligence will also impact the way DSOs reach out to patients, Ramsey points out. “We’ll have to consider whether we are set up to allow Alexa or Siri to schedule an appointment,” she says. “Can we connect with health-based apps to talk to patients about overall systemic health? Do we embrace the Internet and fully understand what it means for our business?

“I think DSOs will need to use branding to support these themes in their messaging, without compromising an opportunity to build trust with the consumer,” she continues. The ability to deliver cutting edge, quality service, while building trust with the target audience, will be the key to branding moving forward, she adds.

OMNICHROMA: One shade fits all

Sponsored: Tokuyama Dental

Meeting the demands of a large patient clientele isn’t always easy. OMNICHROMA by Tokuyama Dental is a unique dental composite solution designed to meet the needs of many.

Kevin M. Brown, DDS, knows his patients expect the very best. From quality care to outstanding results, “our patients have come to expect the best from us, and that is what we intend to deliver,” says the co-owner of Jensen and Brown, a Bellevue, Washington, dental practice that offers a broad range of services, from general and cosmetic dentistry, to periodontics, implantology, endodontics and more. But, as he knows very well, investing in the highest quality products and materials can be costly.

“In our practice we do our best to select materials that are scientifically and clinically proven to be successful functionally, biologically and esthetically,” says Brown. At the same time, steadily shrinking insurance reimbursements have made it more and more challenging to control overhead costs, he notes. “We only participate in a few insurance plans, yet we still feel the pinch.” Something as simple as maintaining three or four composite systems to accommodate a broad range of shades and doctor preferences adds up at the end of each month, he points out.

One shade fits all
When Brown first learned about OMNICHROMA, Tokuyama Dental’s upcoming one-shade-fits-all dental restorative material, he was fascinated by its use of structural color as the main color mechanism, enabling the composite to adapt to any tooth shade. “It is very impressive to apply a dental composite to a tooth and watch it magically transform from an opaque white shade to the exact shade of the tooth, he says. “OMNICHROMA can transform to an A1, a D3 or any other shade the tooth happens to be.

“Having evaluated the OMNICHROMA composite for some time now, I can see that versatility is just one of the many benefits it offers,” he explains. “From a practicality standpoint, OMNICHROMA is a game changer. One composite that can work for over 90 percent of my patients is a dream come true! My dental assistant is thrilled she won’t have to keep track of the 30 or more composite syringes we once stocked, and I am confident OMNICHROMA will save her a significant amount of time and hassle.”

Nor is the financial savings lost on Brown. “Once OMNICHROMA is officially launched in February 2019, we will be able to limit our order to one composite and our overhead will be decreased significantly,” he points out. “In addition, OMNICHROMA offers desirable handling characteristics and excellent polishing ability. My staff and I are grateful to practice dentistry at a time when a technology such as OMNICHROMA is available to make our life easier and ensure our patients are more than satisfied.”

How it works

Most composites today depend on the chemical color of the dyes and pigments added to the resin material to emulate certain shades of human teeth. These composites are limited in their ability to shade match. An A1 will not match an A4, and human teeth do not perfectly follow the VITA range.

OMNICHROMA’s Smart Chromatic Technology is the first use of structural color in composite dentistry as the main color mechanism. As ambient light passes through the spherical fillers in OMNICHROMA, they generate red to yellow structural color, the natural colors found in all human teeth. The red-to-yellow color combines with the reflected color of the surrounding tooth to create a seamless match. This technology eliminates the need for pigments or dyes, and the result is an unprecedented color-matching ability combined with excellent mechanical properties and high polishability.

For the dental practice, that means:

  • Simplified inventory management.
  • Reduction of composite shades that only see incidental use.
  • Reduction of unused composite wastage.
  • It will never be short-stocked on a shade.

OMNICHROMA is recommended for:

  • Direct anterior and posterior restorations.
  • Direct bonded composite veneer.
  • Diastema closure.
  • Repair of porcelain/composite.

OMNICHROMA releases February 2019. To learn more or reserve your sample, visit

Special Markets Solutions: Look, Listen, Learn

Sponsored: Ivoclar Vivadent

Whether solo or group practice, patients have come to expect cutting edge product technology delivered in a seamless dental experience. That demand has driven Ivoclar Vivadent’s mission to answer today’s treatment challenges with a unique Special Markets Program (SMP) designed to bring about maximum value. The measure of such a program can be found in its customized approach to education, service and support that can be best described as tailor-made to grow businesses.

In a recent interview with Efficiency in Group Practice (EGP), David Braunstein, national accounts group practice manager for Ivoclar Vivadent, sheds light on the personal service and customized support that their Special Markets Team brings to the table.


EGP: What is Ivoclar Vivadent’s approach to the special markets segment?

David Braunstein

Braunstein: Look, Listen and Learn. At Ivoclar Vivadent, we are constantly monitoring the dental industry and the needs of dental professionals. We feel it’s very important to listen first and gather the facts. We then apply this information into a game plan that best meets the needs for our individual customers. We call it the 3 L’s: Look, Listen and Learn.


EGP: What are the best types of special markets groups for Ivoclar Vivadent?

Braunstein: They are all important. Special Markets Groups (SMG) involve many players. From universities to community health centers to specialized institutions, it’s more than just the DSOs. Each SMG has different needs and approaches. We want to provide maximum value for our partners. Providing a customized approach to education, service and support is what our customers need and deserve.


EGP: What can you expect from working with your dealer and Ivoclar Vivadent’s SMT?

Braunstein: Experience and knowledge. People that can provide ideas and problem-solving solutions. Products that meet the need for everyday dentistry. Partners in success…not just salespeople. Providing tailor-made solutions are what we do best!


EGP: How does Ivoclar Vivadent support education and training for their SMGs?

Braunstein: At Ivoclar Vivadent, we spend countless hours training and educating our team, enabling them to provide product expertise and solutions for our SMG customers and dealer partners. From lunch and learn seminars to customized CE programs to “open house” events, we have a variety of options and ways to help educate your team. At Ivoclar Vivadent, we recognize that learning is a life-long process and we are well positioned to meet your needs.


Braunstein’s sentiments are well backed. In a 2017 article published by EGP, Mario Mariscal, RDA-EF, manager, field development, Pacific Dental Services, agrees. “Ivoclar has a great group of people working for them,” he says. “They are always willing to help our regional back office trainers and supported practices by providing proper knowledge and direction, enabling us to consistently use their products and materials correctly and provide optimal results in the process.”

With an eye toward greatest efficiency, Ivoclar Vivadent’s globally recognized family of products set the pace for high quality, value-based treatment outcomes. And a team mentality around clinician training and education serves this calling. From a state-of -the-art facility to performance reviews, the Special Markets program and team are built to provide customized consistent and modalities to ensure best practices.

A Novel Solution

Sponsored by SDI (North America) Inc.

SDI’s Riva Star is a two-step process silver diamine fluoride (SDF) and potassium iodide (KI) desensitizer.

Periodontal disease affects over 50 percent of adults 30 years and older, according to research by the Centers for Disease Control and Prevention. Because genetics often play a role in periodontal disease, however, some patients mistakenly believe there is little they can do to control it. But, that’s not so, notes Amy Miller, RDH, business development manager, SDI (North America), Inc. Flossing, brushing with a sonic or electric toothbrush, the use of a water flosser and improved nutrition all can help slow down or reverse the disease. “Patients have many options for addressing periodontal disease,” she points out. “It’s important that they work with the entire dental team, from the periodontist to the hygienist and general dentist, to explore the oral antibiotics and mechanical tools available to them. In turn, the dental team should conduct a thorough risk assessment.”

Riva Star: A patented two-step process
Scaling and Root planning – or the process whereby bacteria and tartar are removed from the tooth surfaces and beneath the gums – are common means for limiting periodontal disease. At the same time, periodontal disease can exacerbate tooth sensitivity, making the process more difficult for both the hygienist and the patient. “When the hygienist removes bacteria from the tooth surface, the surrounding tissue shrinks, exposing new and potentially sensitive dentin,” Miller explains. Dentin is sensitive to hot, cold and pressure, and in some cases, patients require anesthesia or nitrous oxide to help them make it through the cleaning process, she says.

SDI’s Riva Star, a next-generation, two-step silver diamine fluoride desensitizer is FDA-approved for use in the United States with the same indication as fluoride varnish, giving patients a novel solution to address their tooth sensitivity with immediate relief and over two years of desensitizing results. Riva Star’s key ingredients include silver fluoride (a silver capsule), which has known antibacterial properties, and potassium iodide (a green capsule), designed to bind silver ions and help avoid darkening around active cavities or decalcification. Both properties treat sensitive areas for up to five teeth. “Not only is Riva Star indicated for post-operative periodontal surgery and hygiene appointments, it’s also great for pre-hygiene for all sensitive and exposed root surfaces,” says Miller. “It is a great insurance policy to be applied by dentists after surgery, before the patient’s anesthesia has worn off.”

Riva Star is a game-changer for all dental practices, including pediatric practices, Miller continues. “Clinicians should consider how many times each day they see patients with exposed root surfaces and sensitivity, preventing them from providing adequate treatment,” she says. “Riva Star is cost-effective, non-invasive and addresses sensitivity with other antibacterial properties. And when used according to the manufacturer’s directions, and the second step (potassium iodide) is applied, any darkening around an active cavity or de-calcification will be mitigated.”

For more information, visit

Needlestick and Sharps Injuries

Dentistry may not be as dangerous as skyscraper construction or racecar driving, but it has its share of risks.

By Dr. Katherine Schrubbe, RDH, BS, MEd, PhD.

Dr. Katherine Schrubbe, RDH, BS, M.Ed, PhD, is an independent consultant with expertise in OSHA, dental infection control, quality assurance and risk management. She is an invited speaker for continuing education and training programs for local and national dental organizations, schools of dentistry and private dental groups. She has held positions in corporate as well as academic dentistry and continues to contribute to the scientific literature.

Dental professionals face a constant risk of sharps injuries and exposure to bloodborne pathogens, especially during the delivery of patient care. They are at particular risk for hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). According to the Centers for Disease Control and Prevention (CDC) studies of healthcare personnel who have sustained injuries from needles contaminated with blood containing HBV, there is a 22 to 31 percent risk of developing clinical hepatitis in cases where the blood is both hepatitis B surface antigen (HBsAg) and HBeAg positive, and a 37 to 62 percent risk of developing serologic evidence of HBV infection. The average incidence of anti-HCV seroconversion after accidental percutaneous exposure from an HCV-positive source is 1.8 percent. And, the average risk of HIV transmission after a percutaneous exposure to HIV-infected blood has been estimated at approximately 0.3 percent.1 Even a risk that small is too great.

Indeed, the Occupational Safety and Health Administration (OSHA) estimates 5.6 million workers in the healthcare industry and related occupations are at risk for occupational exposure to bloodborne pathogens each year, and the approximately 385,000 needlestick and other sharps-related injuries are sustained by hospital healthcare workers alone. Similar injuries are sustained in other healthcare settings such as dental facilities, nursing homes, emergency centers and clinics.2,3 When accounting for both hospitals and other health care settings, studies have estimated that between 600,000 and 800,000 needlestick and other percutaneous injuries occur annually to healthcare workers.4 That said, other studies completed in medical facilities demonstrate that there is considerable underreporting of these injuries.5

Sharps safety protocols
Dental practices – especially large groups and DSOs – are very busy places with tight patient schedules, and many of the instruments and devices that are used are considered “sharps.”  Sharps is a term for devices with sharp points or edges that can puncture or cut skin or other tissue; dental examples include syringe needles, ortho bands/wires, instruments (i.e. scalers), scalpel blades, burs, files, suture needles and broken glass.3

What steps should be followed when a dental healthcare team member sustains an occupational exposure sharps injury? The procedure and protocol for this demonstrate a perfect example of the interconnection between OSHA, a regulatory agency, the U.S. Public Health Service (USPHS) and the Centers for Disease Control and Prevention (CDC).

First aid and reporting
Dental team members who sustain a needlestick or other sharps injury may think that they should wait until the patient procedure is completed to manage and report these injuries, but that is not the case. When a sharps injury occurs, the first priority should be the team member with the injury.

According to the CDC, “first aid should be administered immediately and as necessary after an occupational injury. Puncture wounds from sharps and other injuries to the skin should be washed with soap and water and no evidence exists that using antiseptics for wound care or expressing fluid by squeezing the wound further reduces the risk of bloodborne pathogen transmission; however, use of antiseptics is not contraindicated. Also, the application of caustic agents (e.g., bleach) or the injection of antiseptics or disinfectants into the wound is not recommended. Exposed dental team members should immediately report the exposure to the infection-control coordinator or other designated person, who should initiate referral to the qualified healthcare professional and complete necessary reports.”6

According to OSHA, “exposure incidents should be reported immediately to the employer since they can lead to infection with HBV, HCV, HIV or other bloodborne pathogens. When a worker reports an exposure incident right away, the report permits the employer to arrange for immediate medical evaluation of the worker. Early reporting is crucial for beginning immediate intervention to address possible infection of the worker and can also help the worker avoid spreading bloodborne infections to others.”7 Thus, it is crucial to manage and report these injuries without hesitation or worry about workplace repercussions; accidental injuries can happen.

Medical evaluation and follow-up
OSHA’s Bloodborne Pathogens standard (29 CFR 1910.1030) requires employers to make immediate confidential medical evaluation and follow-up available for workers who have an exposure incident, such as a needlestick. The standard states this evaluation and follow-up must be:

  • Made available at no cost to the worker and at a reasonable time and place.
  • Performed by or under the supervision of a licensed physician or other licensed healthcare professional.
  • Provided according to the recommendations of the USPHS current at the time the procedures take place. In addition, laboratory tests must be conducted by an accredited laboratory at no cost to the worker.7,8

The CDC defines and outlines specific information to be included in the exposure incident report, which is recorded in the exposed dental team member’s confidential medical record and provided to the qualified healthcare professional for medical evaluation and follow-up. This includes:

  • Date and time of exposure.
  • Details of the procedure being performed.
  • The type of device used, and how and when it was being used, when the exposure occurred.
  • Details of the exposure, including the type and amount of fluid or material and the severity of the exposure.6

Additional information should be included in the report as well, including:

  • Whether the source material was known to contain HIV or other bloodborne pathogens and, if the source was infected with HIV, the stage of disease, history of antiretroviral therapy and viral load, if known.
  • The exposed person’s hepatitis B vaccination and vaccine-response status.
  • Details regarding counseling, post-exposure management and follow-up.6

The report, along with the job description of the exposed dental team member, must be taken to the medical provider that performs any serological tests. Records of all employees with occupational exposure must be maintained for 30 years after the employee terminates employment.8

Serological testing
According to OSHA, a worker who participates in post-exposure evaluation and follow-up may consent to have his or her blood drawn for determination of a baseline infection status of HBV and HIV, but has the option to withhold consent for HIV testing at that time. In this instance, the employer must ensure that the worker’s blood sample is preserved for at least 90 days, in case the worker changes his or her mind about HIV testing.3,7 Although testing is an option for the exposed and injured dental healthcare worker, it may help to preserve peace of mind during the entire post-exposure process. As an example, although HIV infection following an occupational exposure occurs infrequently, the emotional effect of an exposure often is substantial; therefore, giving an exposed person access to persons who are knowledgeable about occupational HIV transmission and who can deal with the many concerns an HIV exposure might generate is an important element of post-exposure management.It is a good practice to seek a health clinic or medical provider who specializes in occupational health as the clinic or provider of choice for any post-exposure follow-ups.

The source individual 
The source individual is any patient whose body fluid is involved in the exposure incident.3 According to the CDC, if the HBV, HCV and/or HIV infection status of the source is unknown, the source person should be informed of the incident and tested for serologic evidence of bloodborne virus infection as soon as possible. Procedures should be followed for testing source persons, including obtaining informed consent in accordance with applicable state and local laws. Any persons determined to be infected with HBV, HCV, or HIV should be referred for appropriate counseling and treatment. Confidentiality of the source person should be maintained at all times.6

When dental team members sustain a sharps injury and have possible exposure, OSHA requires that post-exposure follow-up include counseling the worker about the possible implications of the exposure and his or her infection status, including the results and interpretation of all tests and how to protect personal contacts. In addition, post-exposure prophylaxis for HIV, HBV and HCV, when medically indicated, must be offered to the exposed worker according to the current recommendations of the U.S. Public Health Service.7

The written opinion
Once the medical healthcare provider has evaluated the employee and source patient’s test results, a written opinion is generated. According to OSHA’s standard, the employer must obtain and provide the injured employee with a copy of the evaluating healthcare professional’s written opinion within 15 days of completion of the evaluation. The written opinion should only include whether hepatitis B vaccination was recommended for the exposed worker; whether or not the worker received the vaccination; and that the healthcare provider informed the worker of the results of the evaluation and any medical conditions resulting from exposure to blood or OPIM, which require further evaluation or treatment. Any findings other than these are not to be included in the written report.7 All other medical information must remain confidential per HIPAA laws.

Although the process may seem cumbersome, if policies and protocols are in place, managing a sharps injury should be a streamlined and seamless process. Again, in large group practices and DSOs the infrastructure for a standard operating procedure or protocol should be in place. The flow-chart below illustrates the process for post-exposure evaluation and follow-up in a straightforward manner.9   This can be used as an initial resource for practices that are working to establish a protocol.

Source: American Dental Association

Dental team members and practice management teams should not take the risk of sharps injuries lightly. In the provision of dental care, risk is present and any needed follow-up from an occupational exposure sharps injury must be completed in a timely and efficient manner. The CDC recommends that all dental practices establish written, comprehensive programs that include hepatitis B vaccination and post-exposure management protocols.1,10 The safety and health of the dental team members must be a priority in all practice settings.


  1. Centers for Disease Control and Prevention. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV and HIV and Recommendations for Postexposure Prophylaxis. MMWR Morbid Mortal weekly Rep 2001;50(RR-11). Available at Accessed September 17, 2018.
  1. US Department of Labor – Occupational Safety and Health Administration. Healthcare Wide Hazards- Needlestick/Sharps Injuries. Available at Accessed September 13, 2018.
  1. Miller CH, Palenik CJ. Infection Control and Management of Hazardous Materials for the Dental Team. 5th ed. St. Louis: Mosby Elsevier; 2013;198.
  1. American Nurses Association. Fact Sheet. Available at Accessed September 14, 2018.
  1. John Hopkins Medicine. Medical Students Regularly Stuck by Needles, Often Fail to Report Injuries. Available at Accessed September 14, 2018.
  1. Centers for Disease Control and Prevention. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV and HIV and Recommendations for Postexposure Prophylaxis. MMWR Morbid Mortal Weekly Report 2001;50(RR-11). Available at Accessed September 17, 2018.
  1. Occupational Safety and Health Administration. Fact sheet: Bloodborne Pathogens Exposure Incidents, 2011. Available at Accessed September 17, 2018.
  1. US Department of Labor. Occupational Safety and Health Administration. Bloodborne Pathogens Standard; 1910:1030. Available at Accessed September 14, 2018.
  1. American Dental Association. Employer Obligations After Exposure Incidents OSHA. Available at Accessed September 18, 2018.
  1. Centers for Disease Control and Prevention. Guidelines for Infection Control in Dental Health-Care Settings — 2003. MMWR 2003;52(No. RR-17);13.

Editor’s note: Dr. Katherine Schrubbe, RDH, BS, M.Ed, PhD, is an independent compliance consultant with expertise in OSHA, dental infection control, quality assurance and risk management.  She is an invited speaker for continuing education and training programs for local and national dental organizations, schools of dentistry and private dental groups. She has held positions in corporate as well as academic dentistry and continues to contribute to the scientific literature. Dr. Schrubbe can be reached at

Periodontal disease

Understanding the risks of periodontal disease can motivate patients to adhere to a good oral homecare routine.

Periodontal disease begins with gingivitis – a mild form that causes the gums to become red, swollen and prone to bleeding. The good news is that, with professional treatment and good oral homecare, the disease is reversible.

Left untreated, however, gingivitis can advance to periodontitis. Plaque can spread and grow below the gum line over time, and toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response, causing the tissues and bone that support the teeth to break down. In turn, the gums separate from the teeth, forming pockets, which can become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Eventually, teeth can become loose and may need to be removed.

The most common forms of periodontitis include:

  • Aggressive periodontitis.Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction, and familial aggregation.
  • Chronic periodontitis. Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
  • Periodontitis as a manifestation of systemic diseases. This often begins at a young age. Systemic conditions, such as heart disease, respiratory disease and diabetes, are associated with this form of periodontitis.
  • Necrotizing periodontal disease. Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such, as HIV infection, malnutrition and immunosuppression.

Source: The American Academy of Periodontology. For more information visit

OSAP Dental Infection Control Boot Camp™

The Organization for Safety, Asepsis and Prevention (OSAP) – a community of clinicians, educators, policy makers, consultants and industry representatives who advocate for the Safest Dental Visit™ – will host its Dental Infection Control Boot Camp™ January 23-25, 2019, in Atlanta, Georgia at the InterContinental Buckhead Atlanta. The Dental Infection Control Boot Camp is a core educational course covering all the basics in infection prevention and safety, and a crucial building block for every dental professional with infection control responsibilities.

The program

National and international experts in infection prevention and patient safety will deliver a comprehensive curriculum. The course starts at 7:30 a.m. on Wednesday, January 23, and will conclude at 5:00 pm on Friday, January 25, for civilians.

Federal Services attendees will have additional training sessions on Wednesday afternoon, January 23, and Saturday morning, January 26.

OSAP will feature a special product presentation fair on Friday, January 25. Product personnel also will be invited to demonstrate their products during breaks on January 25. OSAP Corporate members receive a special discounted rate.

The Boot Camp curriculum, along with information on the faculty, the agenda, continuing education and other details regarding the educational program, will be posted is posted online.


Who should attend?

The OSAP Dental Infection Control Boot Camp is targeted to the following individuals:

  • Infection control coordinators in busy dental practices.
  • Educators responsible for infection prevention and safety instruction.
  • Compliance officers in group practices and on dental boards.
  • Federal service employees responsible for infection control in their duty stations. (There will be additional training sessions for Air Force, Army, Navy, Coast Guard, Public Health Service and

Veterans Administration attendees.)

  • Federally Qualified Health Center (FQHC) personnel responsible for infection control.
  • Consultants and sales representatives who want to demonstrate a CORE level of infection control competency.

The program will offer 24 hours of continuing dental education (CDE) credit. Federal Service personnel may qualify for an additional 4 hours of CDE credit.


2019 Basic Training
January 23-25, 2019, Atlanta, GA
Registration Open!
Registration Fees Early Pricing by
Received after
Received after
OSAP Members and
Federal Service Personnel
$395  $475  $550
Non-members $595  $675  $750
Additional Attendees from Same Facility $295  $375  $450
Click HERE to Register today!

The deadline for hotel and course registration is Monday, December 31, 2018. After December 31, 2018, there will be a $75 surcharge to register if space is available.

Cancellations received in writing by December 31, 2018, will be eligible for a refund. A $75 administrative fee will be applied to all refunds. Cancellations received after December 31, 2018, will not be eligible for refunds.

Special Accommodations
Attendees who require special accommodations to participate in the 2019 OSAP Dental Infection Control Boot Camp should include a description of their needs with their registration.

Networking and photos
OSAP will offer registrants contact information to facilitate networking after the course. By registering, attendees give OSAP permission to include their name and contact details on the list. Those who do not wish to be included on the list should email their exclusion request to by December 31, 2018.

In addition, OSAP will take photos during the course. By registering, attendees give OSAP permission to use any images taken at the course in which they appear, as well as any written comments they submit on evaluation forms.

Questions about the program, logistics or registration should be directed to:

Phone: +1 (410) 571-0003 | US & Canada: +1 (800) 298-6727
Mailing Address:  3525 Piedmont Road | Building 5, Ste 300 | Atlanta, GA 30305 | USA

Click HERE for details, including the special OSAP discounted room rate, group transportation options and other travel details.

Editor’s note: OSAP focuses on strategies to improve compliance with safe practices and on building a strong network of recognized infection control experts. The organization offers an online collection of resources, publications, FAQs, checklists and toolkits that help dental professionals deliver the Safest Dental Visit for their patients. Plus, online and live courses help advance the level of knowledge and skill for every member of the dental team. For additional information, visit

Be The Leader They Want

By Lisa Earle McLeod

A recent Forbes article revealed that 65 percent of people would rather have a different boss than a raise.

Take that in for a moment: People would trade money for a better boss

Words of leadership wisdom
When I was 25 years old, my father shared something with me that forever altered my perspective on leadership. I had just been promoted to my first manager position at Procter & Gamble. I called my father to give him the good news.

“Congratulations,” he said, “You’ve just become the second most important person in the life of your employees.”

“What do you mean?” I asked.

He explained, “Next to your spouse, your boss has the power to make your life wonderful or miserable.”

At the time, his comment petrified me. At the ripe old age of 25, half my team was twice my age. I was scared to death because I knew my father was right.

Your leadership makes an impact
Think about your bosses and the impact they’ve had on you. Your boss is a presence at the family dinner table, in conversations with your friends, with your parents.

When I was a kid we talked about my Dad’s boss, Mr. Keck, almost every night. I knew when he was in a good mood or bad mood. I knew about his family.

My mother was a schoolteacher. I knew about her principals – the good and the bad. I even knew about the time one of them had a breakdown when she was getting divorced.

If you’re the boss, you’re a looming presence in the lives of your people, whether you like it or not. You have the power to create happiness, or misery.

How to be a great leader
After working with thousands of employees and leaders, I can tell you, the one mantra that will make you a better boss: Be all in.

People want a boss who cares and who isn’t shy about showing it. Great leaders don’t shy away from emotion. They love their job, they love their customers, and they love their team. And they’re not afraid to let everyone know it.

For them, business is personal. They don’t shy away from difficult conversations. They care enough to address the tough stuff, head on. They give direct feedback.

Great leaders are attuned to the emotional undercurrents of their organization. They’re not perfect, but their team knows their passion comes from their belief in a cause bigger than themselves.

As a leader, you’re the one who tells your people whether this is just a job, or if their work actually matters. For great leaders, work is more than just a transaction – it’s a chance to make a difference in the lives of other people.

They build a tribe of True Believers because they’re all in.

What will your team say about you?
I wrote Leading with Noble Purpose to help leaders emotionally engage with their people. It’s a call for today’s managers to become the kind of leaders a team wants to follow.

As the late Maya Angelou said, “I’ve learned that people will forget what you said. People will forget what you did. But people will never forget the way you made them feel.” Your team is going to talk about you at their dinner tables whether you like it or not.

You can be the leader whose team experienced their work as just a grind. Or you can be the leader whose people say, “She really cares.” The choice is yours.

What steps do you have to take to be the kind of leader your people want?